Rises in intracellular Ca(2+) concentration ([Ca(2+)](i)) caused by progesterone, an inducer of the acrosome reaction, or by cyclic nucleotides, possible second messengers, were investigated by Ca(2+) imaging of the head of individual mouse sperm. Progesterone induced a [Ca(2+)](i) rise in a dose-dependent manner (4-40 microM), primarily in the postacrosomal region. For 20-microM progesterone, Ca(2+) responses occurred in 42% of sperm, separated into two types: transient type (60% of responding cells; duration, 1-1.5 min; mean amplitude, 335 nM) and prolonged type (40%; >3 min; 730 nM). Prolonged responses required higher doses of progesterone, and their occurrence was enhanced significantly by preincubation for 2-4 h as compared with transient responses. 8-Bromo-cGMP (0.3-3 mM) induced a [Ca(2+)](i) rise more effectively than did 8-bromo-cAMP. For 1-mM 8-bromo-cGMP, 90% of cells exhibited transient Ca(2+) responses (approximately 1 min; 220 nM), independently of the preincubation time. In Ca(2+)-free medium, most sperm showed no Ca(2+) response to progesterone and 8-bromo-cGMP. Pimozide, a Ca(2+) channel blocker, completely blocked prolonged responses and partially inhibited transient responses. These results suggest that progesterone activates at least two distinct Ca(2+) influx pathways, with fast or slow inactivation kinetics, and some sperm show both types of response. A cyclic nucleotide-mediated process could participate in the progesterone-induced [Ca(2+)](i) rise.

Leuprolide 1.88 induced pituitary down regulation more rapidly than buserelin MP. However the hypoestrogenic symptoms such as hot flashes were more severe in cases treated with leuprolide 1.88 than in those treated with buserelin MP. Our data confirm that the therapeutic efficacy of buserelin MP and leuprolide 1.88 are similar, with both being sufficient to treat uterine leiomyomas and endometriosis.

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Patients with PCOS as diagnosed based on the Japanese diagnostic criteria include those with increased and normal androgen levels. LOD is considered an effective ovulation induction method for both types of patients with PCOS.